Appendix 3 J Program List of Additional Data Elements Not in SEVIS

Appendix 3 -- J Program List of additional data elements not in SEVIS These listings are based on information available as of 11/2009. Since SEVIS II is still under development, it is subject to change and should be used as a general guide only. Monitor information released by the Exchange Visitor Program for the most current information. Sponsor Information Website (optional) Telephone (optional) Fax (optional) Email (optional) Employer Identification Number (for Form 7002) DUNS Number (optional) (for Form 7002) Sponsor Name Change Justification (text and/or attachment) Redesignation Supporting Narrative (Text and/or attachment, optional) Annual Report Program Evaluation Program Expansion Justification (Text and/or attachment)

Chief Executive Officer/President/Equivalent Information Telephone Fax (optional) Cell phone (optional) Email PIN (for Signature

Responsible Officer/Alternate Responsible Officer Information Call Phone (optional) Proof of Citizenship when being added as Ro/ARO (Text and/or Attachment) PIN (for signature)

Payer Information Name Position title Telephone Fax (optional) Cell Phone (optional) Email Exchange Visitor Information Program Specific ID (Optional): Number assigned by sponsor (NOT the IIN) Last Legal Permanent Residence: Email: Telephone (optional): Cell Phone (optional): Mailing Address: Host Family or boarding school residential address: Primary Host Family contact: Secondary Host Family Contact (optional): Boarding School Name: Boarding School Telephone (optional): Local Community Coordinator (optional): Current Site of Activity: (changed from Primary site) Funding Sources for Binational Commission and Exchange Visitor Government PIN (for signature) Third Party Certification (T/IPP) Number of Years Experience in Field or Profession (T/IPP, optional) Type of Degree or Certificate (T/IPP) Date Awarded or Expected (T/IPP) Phase Name (T/IPP) Field of Training/Internship (T/IPP) Phase Start Date (T/IPP) Phase End Date (T/IPP) Hours per Week (T/IPP) Stipend (T/IPP) Supervisor First name (T/IPP) Supervisor Last name (T/IPP) Supervisor Position Title (T/IPP) Supervisor Email Address (T/IPP) Supervisor Email Address (T/IPP) Supervisor Telephone number (T/IPP) Description of Trainee/Intern’s Role (T/IPP) Specific goals and Objectives (T/IPP) Knowledge, Skills, or Techniques to be Imparted (T/IPP) Methods of Performance Evaluation and Supervision (T/IPP) Specific Tasks and Activities to be Completed (T/IPP) Methodology of Training and Chronology/syllabus (T/IPP) Journal Comment type Journal Comment Template Name Template Description Effective Date of Matriculation

Spouse and Dependents Program specific I.D. (optional) (assigned by sponsor (NOT IIN) Email Telephone (optional) Cell phone (optional)

Printed Forms DS-2019D - Domestic DS-2019 DS-7002 – T/IPP (DS-7002) DS-3097 – New Annual Report Can be printed in draft for internal review/to be submitted electronically to DoS